_Recruiting volunteers to serve as custodians.
_Relax the licensure requirements of health practitioners as necessary.
Dr. Tom Betz, acting state epidemiologist for Texas, said the national plan validated much of the work his state has done over the past three years.
"Our approach just mirrors what's in the national plan," Betz said. "To me, what was nice about the national plan was that it was not a sky-is-falling approach. It really stressed the need for vaccine as one our primary tools in fighting any strain of influenza."
The completion of 50 state plans for a flu pandemic is a top priority of the federal government, because as one top Bush administration official said, a battle against a pandemic will be fought on 5,000 different fronts.
"The federal government can deliver stockpiles of medication and supplies to a city in the U.S. in a matter of hours, but it is distribution at the state and local level that defines victory," said Health and Human Services Secretary Mike Leavitt.
A review of several state plans shows they have taken stock of the potential toll. The projections for some of the worst-case scenarios are ominous. Texas cites the potential for up to 250,000 deaths if 25 percent of the population were infected. Georgia says up to 6,210 people could die. Kansas predicts the potential for up to 2,500 deaths.
Bird flu has killed at least 62 people since it surfaced in 2003, all in Southeast Asia, according to the World Health Organization. Most had contact with sick poultry. But health experts have warned that the virus could mutate into a form that can be easily transmitted between humans and trigger a global pandemic.
States have planned for a potential pandemic for several years, and they've taken cues from the Centers for Disease Control and Prevention and the World Health Organization in forming those plans. However, their work has taken on greater urgency in recent months, said Patrick McConnon, executive director of the Council of State and Territorial Epidemiologists. Several states have submitted new plans to his association in recent weeks. Most plans are labeled as drafts.
In June 2004, 29 of 50 states had plans in place for a potential pandemic. Since then, the remaining states have at least completed drafts of a plan, he said.
Most states plan for shortages of medicine, and they realize they will have to make some tough decisions. Most also have been inexact when saying who would be the first in line to get medicine. For example, Kansas states that it will listen to recommendations made at the national level. Its current priority list starts with hospital and health department staff, as well as their family members. Next in line are emergency medical workers, police officers and firefighters. Last on the list are members of the "general public."
Georgia says the state's health director may choose a committee to help decide who would get drugs first. The committee would include health officials as well as experts on ethics. Some protest from the public should be expected, it hints.
